Meet Jim. He's a 59-year-old husband whose wife has several back issues. He posed a detailed and rather captivating question to an online forum where chronic pain warriors vent about real-life issues. He wants to find out if surgery is the route his wife should take for her pain relief.
“My wife has been diagnosed with degenerative disc disease and scoliosis (age 53). Her pain is quite severe. She has been on so many different types of medications that I have lost count. From narcotics ER and IR to muscle relaxers. At least two different types of injections. She also uses a TENS unit. She has tried PT with little success. She could not bring herself to wear a back brace because the one ordered had to be worn on the outside of her clothing.
Currently, she takes up to 50 milligrams of Percocet (10 milligrams four to five times a day) and that seems to be the only thing that works and that dosage has been nearly doubled within a year. Her pain management doc has just about run through everything available and probably will recommend surgery in the near future. My wife is extremely fearful of any back surgery. We have family and friends who have horror stories concerning their back surgery. So I would like to hear from some of you who have gone down this road. Any advice, any experience with back surgery or even deciding against back surgery. Any other options any of you have dealt with or considered. Thanks!
Although there is no firm yes or no answer to Jim's questions, one user's remarks stood out.
Meet Susie. She is one of the forum's moderators and a psoriasis patient.
Hello Jim and welcome to the forum. I am sorry to hear that your wife is having such difficulty and it does sound like she has used up a lot of her options at this stage. But, you know in reality, if every back surgery was a failure they would not keep letting doctors do these surgeries. Probably one of the worse things that has happened to your wife is listening to family & friends talk about their surgeries. For some reason when you start talking surgery of any kind to family or friends, the horror stories they come up with is enough to scare a person to death.
One thing I suggest is she consult with a board certified neurosurgeon. These doctors deal more with the nerves and think about it, they do brain surgery. They have more schooling for this area than an orthopedic surgeon. The ortho's specialty is more skeletal. I have seen much better outcomes with a neurosurgeon that an ortho. If she has not been seen one I would encourage her to get in with one. Sometimes, waiting too long to have surgery can work against a person too, especially if they have a pinched nerve. The nerve can sustain permanent damage if left too long, then no surgery can improve that situation. Tell your wife good luck with her surgery!
If you can relate to Jim's situation and his questions, you're reading the perfect article. Between physical therapy, aqua therapy, massages, pain medication — you name it, it's been tried — and doctor visit after doctor visit, you or your loved one are finding no relief in sight.
Are we right? Are we close in describing that you (or a loved one) has tried everything to relieve chronic back pain? Are you like Jim — do you have questions that need answers?
At this point, maybe your medical team is in the process of deciding if surgery is right for you. If that's the case, and you're now looking to weigh the pros and cons, we've got you covered!
Let's get right to it.
First things first. You definitely want to be prepared with questions before you see the doctor. A special thank you to Next Avenue — a public journalism service for America’s booming older population. Their daily content delivers vital ideas, context and perspectives on various health issues that matter most as we age. Even if you are not apart of the elderly community, trust us, these are solid questions.
What Questions Should I Ask My Physician?
- What are the side effects, potential risks and potential complications of the surgery?
- How do the risks relate to me personally?
- What are the long-term consequences of the proposed procedure?
- Why do I need to get an MRI, CAT scan and an X-ray before I have surgery?
- How long will I be in the hospital?
- How long is the recovery?
- After surgery, how long will my pain last?
- Will I have to take pain medication after my surgery? Will I become dependent?
- Do I have to wear a brace?
- Will I need physical therapy afterward?
- When can I go back to work?
- How many times have you done this procedure?
- Are you board-eligible or board certified?
- Are you fellowship-trained in spine surgery?
- Statistically, what is the success rate for this type of surgery?
- What is your personal success rate, and how many cases of this type of surgery have you done?
- May I talk to the last five patients on whom you’ve done a similar procedure
What are the Benefits?
Let's say you've had surgery and the result was the best case scenario. After you recover (and don't rush the process), you may find that you:
- Feel less pain
- Can move around better
- Remain more physically fit and active
- Have mood improvements
- Don't need to take as much pain medicine
- Can go back to work
- Feel as if you can finally be more productive at work and life
What are the Risks?
Although extremely rare, there are risk factors for any operation. Thanks to modern medicine, this risk is now less than 1 in 10,000. We hope this puts any anxieties of yours at ease, but there risks. Some surgical risks include:
- Negative reaction to anesthesia or other drugs
- Blood clots in your legs or lungs
- Heart attack
- Nerve damage that can lead to weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control
- Failed back syndrome (FBS), which is a condition characterized by chronic pain following back surgery.
- Common symptoms associated with FBS include diffuse, dull and aching pain involving the back or legs. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. The term "post-laminectomy syndrome" is used by some doctors to indicate the same condition as failed back syndrome.
Bringing it Home
The odds that something could go wrong also depends on any other health conditions you may have. The associated risks vary by the type of surgery. Part of your surgeon's job is to identify potential problems before going under the knife— making it a medical necessity to speak with your doctor before being strolling to the operating room.
We are going to leave you with one last response to Jim's important question (although we are always here).
Another forum moderator and back pain surgery success story female shares her experience on how surgery changed her life — for the better. Meet Merrida. She shared this with Jim:
I had my back surgery 12/12/12. I put it off as long as possible as well. The only regret is that I didn't do it a little sooner. People wait, but younger, healthier bones/bodies heal better than elderly, fragile structures, yet they comprise the bulk of a surgeon's work.
I am 50. At 49, I had a total hip replacement on the left [side]. Then in December, I had a spinal reconstruction of L1 through L5, titanium cage, screws [which] required a bone marrow graft and bone grafts, both taken from my pelvis. Then recently on June 10, I had my right hip replaced.
I would do it all again in a heartbeat.
I'm glad for the time I had postponing surgery. I knew this time would come eventually. With me, my neurosurgeon, the head of the department at Tufts in Boston, a teaching hospital, admitted I was a very complex case. I had some nerve damage, some that may never recover, but I'm hoping. Waiting too long, you can get permanent damage.
As for needing surgery in the future, my opinion is: Yeah, well, that's life. If I want to take care of myself it's called maintenance. Nothing "fixes" or "cures" anything and we are always repairing or taking care of ourselves. Some of us just need more intensive means.
I'm early in the game, but I am happy I had it done. I had an excellent surgeon. The first neurosurgeon I saw was honest and referred me to a major hospital, and to a surgeon who handles "difficult cases,” usually trauma. I wouldn't hesitate to return to him IF I need to. And I had extremely invasive and complicated work done to my spine in high-risk areas. I think that I'm realistic and that makes me feel like this is a success.
We all want a story like Merrida (and maybe a caring spouse like Jim; are we right?) Regardless if you decide to have surgery or not, it's always important to talk to your doctor about everything. If you don't feel well enough to do personally, ask a family member or close friend to assist, just like Jim did for his wife.